Exploratory mixed-methods analysis of the determinants of use of health research evidence among planning teams in Tanzania.

Abstract

Introduction: Achieving universal health coverage requires the use of health research evidence in decision-making; however, this remains understudied in lower and middle-income countries (LMICs) such as Tanzania. Despite several health sector reforms and the availability of locally generated research, evidence indicates that the use of such research in health planning and decision-making remains limited in Tanzania, creating a gap between research production and its practical application. This study examined the extent of research evidence used in health planning and the factors influencing its use among health planning teams.

Methods and analysis: A sequential exploratory mixed-methods design was employed, starting with qualitative data from focus group discussions (N=6) and KIIs (N=34) with health planners from selected regions in Tanzania, recruited based on their direct involvement in health planning, using semistructured guides informed by the Capability, Opportunity, Motivation-Behaviour (COM-B) model. This was followed by a quantitative survey of 422 participants meeting the same inclusion criteria, administered with a structured questionnaire derived from the model. The COM-B framework guided both tool development and analysis. Qualitative data were thematically analysed using a framework approach, yielding three themes, while quantitative data were analysed using descriptive statistics and binary logistic regression.

Results: Qualitative findings revealed barriers such as limited knowledge and skills, inadequate access to knowledge translation tools, poor dissemination processes, financial and technical constraints, and lack of training. Opportunities included supportive guidelines, research coordinators, collaborations, dedicated budgets and improved internet access. Motivators such as job promotions, professional development, allowances and targeted training were also identified. Quantitative results showed moderate evidence use (66.2%), slightly higher than in other LMICs. Barriers included suboptimal dissemination (74.5%; OR=2.035, p=0.0008), inadequate resources (70.0%; OR=0.965, p=0.8759) and lack of training (63.7%; OR=1.361, p=0.1806). Integrated findings highlighted convergence on dissemination, resource and training challenges, with divergence in statistical significance between methods.

Conclusions: Barriers related to dissemination, resources and training hinder evidence use. Interventions such as digital repositories, guideline development and capacity building, alongside institutionalised frameworks, resource allocation and accountability mechanisms, are essential to strengthen evidence-based health planning in Tanzania.